Patients interested in Hybridge, please visit Hybridgeimplants.com
Patients, are you interested in Hybridge Dental Implants? Visit: Hybridgeimplants.com
Even the smallest parts of a full-arch restoration can have a major influence on strength, accuracy, and longevity. In this episode, Dr. Frank Lamar and Dr. Julian Conejo discuss the evolving role of conical screws in digital workflows, why they’re becoming the industry standard, how they integrate with 3D-printed prosthetics, and what clinicians should know about their advantages and limitations.
Welcome back to The Lasting Smile Podcast, where clarity meets innovation in full-arch dentistry. In Episode 4, Hybridge Founder Dr. Frank Lamar and Clinical Lab Director Dr. Julian Conejo take a closer look at one of the smallest but most critical elements of restorative success, the implant screw.
With digital printing, fully zirconia frameworks, and new prosthetic designs transforming implant workflows, screw design has evolved too. The discussion explores why conical screws are gaining popularity, how they complement modern materials, and what clinicians need to know to ensure strength, passivity, and long-term durability.
Though small, implant screws play a huge role in full-arch success. As Dr. Lamar notes, “It seems like a small thing, but when a screw fails, the entire system is compromised.” The move toward 3D-printed provisionals and fully zirconia prosthetics has made screw design more critical than ever.
The name says it all, conical screws feature a tapered, cone-shaped head. This design allows them to clamp the framework to the implant more securely, improving long-term stability and reducing screw loosening compared to traditional flat-head screws.
As 3D printing becomes integral to full-arch dentistry, conical screws are proving indispensable. They better distribute force across printed resin provisionals, preventing screw heads from fracturing through thin layers of material, a common issue with flat screws in printed prosthetics.
Fully zirconia prosthetics are incredibly strong but brittle at their thinnest points, especially around implant interfaces. Because conical screws occupy less internal space, they leave more zirconia around the connection, reinforcing one of the prosthesis’s most vulnerable areas.
In both digital prototypes and final restorations, conical screws improve mechanical engagement and stress distribution. Their geometry helps create a tighter, more passive fit at the implant interface, minimizing micromovement and the potential for long-term fatigue.
Modern CAD/CAM systems now include digital libraries for conical screws, allowing designers to model precise geometries directly in their workflows. Some screw systems even feature misangulation correction, letting clinicians reposition screw access holes to avoid esthetic zones like incisal edges or buccal cusps.
Conical screws require specific drivers and seating tools, and clinicians must ensure compatibility with their implant systems. Many implant manufacturers are now adapting this technology into their own product lines, signaling an industry-wide shift toward conical geometry.
Even with their strength advantages, conical screws cannot overcome poor passivity. As Dr. Lamar cautions, “If your prosthetic isn’t perfectly passive, it doesn’t matter what kind of screw you have.” Over-tensioned frameworks can damage threads and implant interfaces, negating the benefits of advanced screw designs.
For full-arch zirconia restorations using conical screws, photogrammetry is essential. This ultra-accurate implant capture method minimizes misfit and ensures every screw seats correctly. Without it, inaccuracies can compound and lead to catastrophic failures over time.
As Dr. Lamar concludes, new technologies like conical screws and 3D-printed provisionals are valuable tools, but success still depends on workflow integration. Knowing how to combine materials, design principles, and accurate data capture is what truly guarantees “a lasting smile.”
Conical screws may be small, but their impact on digital full-arch dentistry is enormous. They improve precision, protect materials, and support modern workflows, but only when paired with proper passivity, accurate data, and thoughtful design. At Hybridge, innovation is never about a single component, it’s about how every piece fits together seamlessly.
Dr. Frank Lamar is the founder of Hybridge and a pioneer in full-arch restorative dentistry.
Dr. Julian Conejo is Hybridge’s Clinical Lab Director and a prosthodontist specializing in digital workflows, implant design, and restorative integration.
